Spinal Headache Help?

[clemsontiger28]

Hello. Any advice would be greatly appreciated. 2 months ago I had a L5/S1 Laminectomy/Discectomy and 1 month ago I developed a sudden, severe and debilitating headache. I never really had a headache of any significance until this point in my life. I have severe pressure and pain in my sinus, base of skull and forehead. I also feel intense pressure pushing out towards the top of my head. The headache is also very positional. It gets much worse when I am upright but almost completely goes away when I lay down for about 20 min or so. I have had this for about 1 month and 1/2 now and feel like I am at least "coping" w/ the pain better but the pressure is always there. Now I can sit up for an hour or two w/o feeling like I am going to die...so maybe it's healing. My surgeon saw something he thought could be fluid on my post op MRI but he thinks conservative treatment is best and he wants me just "wait it out" rather than order a myleogram, another MRI or try a lumbar drain. So far I have been to the ER for a caffeine drip, steroid IV's, tried bed rest for 72 hrs...I am getting pretty frustrated because I was hoping to at least try a blood patch and my surgeon doesn't think it would work in my situation. I have read a lot about blood patches working post lumbar puncture but on the net but not after surgery??? but what do I know..I'm not a doc. I have tried to get a 2nd opinion but no other neurosurgeon will see me for another few months b/c I just had back surgery. He also will not give me any more pain med's b/c he wants to wean me off my caffeine pills. I am only taking 2 a day and I don't know if I will be able to function at all  w/o them because my head hurts so bad.  I have to go back to work or I will lose my job and I have a baby to take care of so any advice is greatly appreciated. Thank you for reading my post.

[lizzie01]

Hi, av had third discectomy on  my L4/L5 disc in May this year and they cut my spinal cord by accident and I had to do a 24 hour lie down cause the fluid from my brain was leaking and am now 2 weeks ago getting bad headaches and the nerve pain in my back and ankle are just as bad.  I dont suffer from headaches ever and have to get B12 injections every three months for life now. I will not let them (neurosurgeons)  near my back now....take care.....

[Abhijeet Ghosh]

Dear Friend,
Well presently we really don't have much option rather than "Wait and Watch".
The options read by you on internet are fine but practically not applicable in your scenario.
The best way is to keep your hydration level good and adequate.This should be able to control the pain part. By this i mean that daily you need to have 3-4 litre of water intake. This is to maintain the amount CSF levels. If the CSF level is not maintained (due to lower fluid), then it results in all those above defined symptoms.
The bad part is that you already are having sinus related problems, so it may aggravate the present issue.
So please continue with the medications prescribed by your doctor and have good water intake and trust him.
Feel free to discuss more.
Regards

[Agggony]

DO NOT NOT NOT Let them do another Myleogram!!! NO MORE POKING HOLES in your spine and causing leaks!!! The Dr.s dont live through what they do to us and some dont care! My anesthesiologist said He would have done the blood patch the 1st day called crying on the phone. Tell the Dr, you want it done under a X-Ray scope so they get it right the 1st time and make thm do it, Dont take no for an answer!! My GOD I feel for you!!  I was hrs from leaving my wife and 3 kids without a father when my Dr got back and called me to come in.

[Agggony]

In a word BLOOD PATCH, They can patch the hole they made where the fluid is leaking with a "Blood Patch"  I know what your going through and hope by now you wont even need to read this. I had a spinal headache for a week following a milligram , The Radiologist/Dr would not listen to me when I told him there was no space to access the spinal fluid in my lumbar but he tried any way tearing the sack around the spinal cord. The throbbing POUNDING was so bad I was vomiting constantly! Had to sit on my hands & Knees with my head jammed into th crack between the cushions of the couch and my Butt high as I could get it to get even a lil relief. My cord was leaking fluid, It even felt like I was sitting in water.
   LONGER HORRIBLE STORY  short They had to do a "Blood Patch" The 1st Idiot missed . The same IDIOT who wouldn't listen to me. A week later my anesthesiologist got back from vacation and he Did a 2nd patch and it sealed the leak before I left the hosp. I was ready to KILL MY SELF By this time and cried tears of joy when the pain started to go away!! You need to have an  anesthesiologist do a BLOOD PATCH, and never ever let anyone near your spinal fluid ever gain, My new pain Dr, keeps pushing Injections but my old anesthesiologist told me that steroid injections are only effective if they are done with in 3 days of the injury and should only be done once because the needles and drugs create scar tissue that make the nerve pain worse.

[Abhijeet Ghosh]

Dear Friend,

1) Have you seen these nasty spinal headaches clearing up on their own after a few months?

     Generally we feel that there are some minor leaks( in the membrane called DURA). These leaks gets healed and hence the symptoms wanes off slowly. Opening the lower back is not always a good option post surgery. That's the main reason, your doctor is not willing to explore it again and you seem to be recovering well.

2) What is the general time frame to allow this to continue before some kind of intervention?  
There is no time frame defined in any text book. It's purely a judgmental call of the treating doctor.
Worsening of the symptoms (headache) or appearance of a bulge over the operated site (excess spinal fluid collection due to leak), calls for operative / secondary intervention.

Feel free to discuss further

[clemsontiger28]

Thank you for your response. Have you seen these nasty spinal headaches clearing up on their own after a few months? What is the general time frame to allow this to continue before some kind of intervention? Thanks so much.